Ultrasonic Neuromodulation for Alzheimer's Disease

Overseen By Jan Kubanek, PhD

Age: 18+

Sex: Any

Trial Phase: Phase 1 & 2

Sponsor: University of Utah

Disqualifiers: Stroke, Suicidal ideation, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new brain therapy for people with Alzheimer's disease. It uses a special ultrasound technique, the Diadem prototype, to target brain areas affected by the disease. Researchers aim to determine if this can improve brain function by comparing two groups: one receives the actual treatment, and the other receives a placebo. Ideal participants have mild memory problems due to Alzheimer's, confirmed by specific tests. As a Phase 1 and Phase 2 trial, the study focuses on understanding how the treatment works and measuring its effectiveness in an initial, smaller group, offering participants a chance to contribute to groundbreaking research.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this ultrasonic neuromodulation technique is safe for Alzheimer's patients?

Research has shown that the Diadem prototype, which employs a gentle form of sound wave therapy, has been generally well-tolerated in previous studies. For example, a study with 120 participants found no serious side effects from this treatment. This therapy is gaining attention for its potential to help people with Alzheimer's disease. Although still under investigation, early results suggest it is safe for humans, as trials have not observed any serious adverse effects so far. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatment for Alzheimer's?

Most treatments for Alzheimer's disease focus on managing symptoms through medications like cholinesterase inhibitors and memantine. However, the Diadem prototype is unique because it uses low-intensity transcranial focused ultrasound to stimulate deep brain areas affected by Alzheimer's. This technique could potentially modify the disease process itself rather than just alleviating symptoms. Researchers are excited because this non-invasive approach might offer a new way to directly influence brain activity and slow the progression of Alzheimer's, offering hope for more effective long-term management of the condition.

What evidence suggests that this ultrasonic neuromodulation is effective for Alzheimer's disease?

This trial will compare active stimulation using low-intensity transcranial focused ultrasound (tFUS) with a sham stimulation. Research has shown that tFUS might help people with Alzheimer's disease. A small initial study found that this method could improve brain function and memory by targeting specific brain areas like the hippocampus, which is crucial for memory. This technique uses sound waves to enhance brain activity without surgery. Early studies also suggest that tFUS might help by temporarily opening the blood-brain barrier, potentially allowing treatments to reach the brain more easily. Overall, the early results are promising, but further research is needed to confirm these effects. ^{1 2 3 5 6}

Are You a Good Fit for This Trial?

This trial is for individuals aged 65-80 with mild cognitive impairment or early-stage dementia due to Alzheimer's, confirmed by specific biomarkers. Participants must have a certain level of cognitive function (MOCA > 18) and be able to complete an MRI. Those with recent strokes, other brain diseases, or suicidal thoughts cannot join.

Inclusion Criteria

I have mild memory problems or mild dementia due to Alzheimer's, confirmed by tests.

MOCA > 18

I am between 65 and 80 years old.

Exclusion Criteria

Suicidal ideation

I cannot undergo an MRI scan.

I have had a stroke or been diagnosed with cerebral amyloid angiopathy in the last year.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Stimulation and Monitoring

Low-intensity transcranial focused ultrasound stimulation delivered with various parameters during psychophysical and physiological monitoring

4 weeks

Multiple visits for parameter testing and monitoring

Blinded Randomized Sham-Controlled Cross-Over Trial

Testing of selected stimulation protocol in a blinded randomized sham-controlled cross-over trial

8 weeks

Regular visits for treatment and assessments

Follow-up

Participants are monitored for safety and effectiveness after treatment using cognitive assessments and imaging

4 weeks

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Diadem prototype

Trial Overview

The study tests the Diadem prototype, which uses low-intensity ultrasound waves aimed at the brain to improve cognition in Alzheimer's patients. It includes initial testing to find a safe protocol followed by a blinded comparison where some get real treatment and others don't.

How Is the Trial Designed?

Group I: Active stimulation Experimental Treatment 1 Intervention

Low-intensity transcranial focused ultrasound stimulation of deep brain targets affected by Alzheimer's disease.

Group II: Sham stimulation Placebo Group 1 Intervention

Sham stimulation that applies the device in the same way as verum but only delivers auditory sounds correspoding to the ultrasonic pulses.

Who Is Running the Clinical Trial?

University of Utah

Lead Sponsor

Trials

1,169

Recruited

1,623,000+

Published Research Related to This Trial

The new transcranial pulse stimulation (TPS) technique using ultrashort ultrasound pulses shows promising safety and efficacy in modulating brain activity, with preclinical studies indicating large safety margins and effective neuromodulation.

In a clinical pilot study involving 35 Alzheimer's patients, TPS treatment led to significant improvements in neuropsychological scores, with effects lasting up to three months and correlating with enhanced memory network activity as shown by fMRI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial Pulse Stimulation with Ultrasound in Alzheimer's Disease-A New Navigated Focal Brain Therapy. Beisteiner, R., Matt, E., Fan, C., et al.[2023]

A new chip-scale device using GHz ultrasonic waves has been developed to stimulate human neural cells, showing promise for improved localization and control in neural prosthetics.

This study is the first to demonstrate that GHz ultrasound can effectively stimulate neurons in vitro without significant thermal effects, indicating a safe and innovative approach for future neural engineering applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

GHz Ultrasonic Chip-Scale Device Induces Ion Channel Stimulation in Human Neural Cells. Balasubramanian, PS., Singh, A., Xu, C., et al.[2021]

The study introduces a novel transcranial focused ultrasound stimulation (tFUS) system that allows for chronic, closed-loop neuromodulation in freely behaving rodents, overcoming limitations of previous preclinical models.

Using this system, researchers found that ultrasound stimulation of the prefrontal cortex can enhance REM sleep and protect spatial working memory during REM sleep deprivation, suggesting potential therapeutic applications for brain disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

General-Purpose Ultrasound Neuromodulation System for Chronic, Closed-Loop Preclinical Studies in Freely Behaving Rodents. Jo, Y., Lee, SM., Jung, T., et al.[2022]

Transcranial ultrasound stimulation (TUS) can non-invasively target both cortical and deep brain structures with high spatial resolution, potentially allowing for precise neuromodulation that was previously only possible with invasive methods.

The mechanism of TUS involves ultrasound waves interacting with neuronal membranes, leading to changes in neuronal excitability, which could have significant implications for both basic research and clinical applications in neuromodulation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Non-invasive transcranial ultrasound stimulation for neuromodulation. Darmani, G., Bergmann, TO., Butts Pauly, K., et al.[2022]

In a study of 18 Alzheimer's disease patients, transcranial pulse stimulation (TPS) significantly improved depressive symptoms as measured by the Beck Depression Inventory (BDI-II) after 2-4 weeks of treatment.

Functional connectivity analysis revealed that TPS normalized connections between brain networks associated with emotion and cognition, suggesting that this non-invasive therapy could be an effective add-on treatment for depression in Alzheimer's patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial pulse stimulation (TPS) improves depression in AD patients on state-of-the-art treatment. Matt, E., Dörl, G., Beisteiner, R.[2022]

Transcranial pulse stimulation (TPS) therapy over 2-4 weeks showed improvements in cognitive performance and functional networks in Alzheimer's disease (AD) patients, with effects lasting up to 3 months.

In a study of 17 AD patients, an increase in cortical thickness was significantly correlated with neuropsychological improvements, suggesting that TPS may help reduce cortical atrophy in critical brain areas associated with memory.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial ultrasound pulse stimulation reduces cortical atrophy in Alzheimer's patients: A follow-up study. Popescu, T., Pernet, C., Beisteiner, R.[2023]

Ultrasound (US) has emerged as a promising non-invasive method to modulate neuronal activity, showing potential to stimulate or suppress nerve function in various models, including peripheral nerves and brain circuits.

The mechanism of action involves the interaction of ultrasound with mechanosensitive ion channels, and its ability to focus on deep-brain regions with high precision makes it a valuable tool for developing advanced neurotechnologies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrasonic modulation of neural circuit activity. Tyler, WJ., Lani, SW., Hwang, GM.[2019]

In a study involving 12 healthy participants, transcranial pulse stimulation (TPS) was shown to significantly enhance the efficiency of the cortical sensorimotor network and improve axonal status in the stimulated area, indicating positive neuroplastic changes.

The effects of TPS were observed to last up to one week after stimulation, suggesting its potential for long-term benefits in treating neurological and psychiatric disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

First evidence of long-term effects of transcranial pulse stimulation (TPS) on the human brain. Matt, E., Kaindl, L., Tenk, S., et al.[2022]

A study involving 120 participants evaluated the safety of low intensity transcranial focused ultrasound (LIFU) for neuromodulation, finding no serious adverse effects and only mild to moderate symptoms reported by 7 participants, which were generally transient.

The symptom profile from LIFU was similar to other non-invasive brain stimulation methods, suggesting that LIFU is a safe option for neuromodulation with manageable side effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A retrospective qualitative report of symptoms and safety from transcranial focused ultrasound for neuromodulation in humans. Legon, W., Adams, S., Bansal, P., et al.[2021]

Ultrasonic waves can be precisely directed and focused to modulate neuronal activity non-invasively, which could revolutionize approaches in neural science and engineering.

Recent studies have shown that ultrasonic neuro-modulation can directly excite or suppress neural activity in both animal models and humans, highlighting its potential for therapeutic applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrasonic neuromodulation. Naor, O., Krupa, S., Shoham, S.[2022]

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Ultrasonic Neuromodulation for Alzheimer's Disease

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